Table of ContentsView AllTable of ContentsPurposeTypesHow to UseApproved MedicationsNebulizersFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Purpose
Types
How to Use
Approved Medications
Nebulizers
Frequently Asked Questions
Childhood asthma causes mild toseveresymptoms that can get in the way of everyday activities and could be life-threatening in certain circumstances. Thankfully, asthma can usually be successfully managed with an inhaler, a handheld device that delivers medications right into the lungs.
Inhalers for kids may contain rescue medication to respond to an emergency asthma attack or maintenance medication that helps prevent attacks from happening.
Verywell / Ellen Lindner
This article helps you understand the types of inhalers available for kids and how these inhalers work. It offers tips on using inhalers correctly and what to do if your child is too young for an inhaler.
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Why a Child Might Need an Inhaler
Inhalers are a mainstay ofasthma treatmentbecause they either help stop an attack or prevent one from happening. To manage childhood asthma, healthcare providers may prescribe one of three types of inhalers for kids:
Long-Term Control of Asthma
Children usually begin to show signs of asthma before age 5. These symptoms may include frequent incidences of:
If you notice these signs, a healthcare provider should examine your child. If asthma is diagnosed, long-term control medication may be prescribed. This can include using a controller or combination inhaler daily to prevent symptoms.
Asthma Attack Treatment
When your child is diagnosed with asthma, your healthcare provider will help you create anasthma action plan, which may include using a rescue inhaler in the event your child has an asthma attack.
The Asthma and Allergy Foundation of America identifies attacks as those in the yellow/caution zone and the red/danger zone.
Symptoms of an attack in the caution zone include:
In children, symptoms of an attack in the danger zone include:
A child who is having an attack with red or yellow zone symptoms should be given a rescue inhaler. At the danger zone stage, you should also call 911 or head to the emergency room.
Asthma Attack Prevention
Some children are diagnosed withexercise-induced asthma(EIA). This is when physical activity may trigger asthma.
In order to prevent an attack, children with EIA may need to use a rescue inhaler 10 to 15 minutes before playing sports or participating in physical activities.
Types of Inhalers
There are three types of inhalers:
Controller Inhalers
Controller inhalers contain corticosteroids, medications that prevent inflammation. This reduces swelling and the production of excess mucus which contribute to wheezing, difficulty breathing, and other common symptoms of asthma.
Inhaled corticosteroids (ICSs)delivered via controller inhalers are important for asthma management. To effectively prevent symptom flares and asthma attacks, they must be used regularly. For most children, this means several times a day according to a prescribed schedule.
When prescribing a controller inhaler for kids, healthcare providers likely will start with the lowest possible dose needed to control your child’s symptoms.
Rescue Inhalers
Rescue inhalers are used as needed—when a child feels they’re having an asthma attack or is about to based on the onset of symptoms (wheezing, chest tightness, shortness of breath, and so on). These inhalers are not meant to be used on a regular basis.
The rescue medication prescribed most often for children (and adults) isalbuterol(also known as salbutamol), a short-acting beta-agonist that relaxes the airways so they can more easily widen. It’s available under a number of brand names as well as a generic medication.
When Should I Worry About My Child’s Asthma?If your child seems to need their rescue inhaler more than twice a week, there may be cause for concern. Let their pediatrician know. Frequent flare-ups of symptoms could be a sign your child’s asthma plan needs to be adjusted.
When Should I Worry About My Child’s Asthma?
If your child seems to need their rescue inhaler more than twice a week, there may be cause for concern. Let their pediatrician know. Frequent flare-ups of symptoms could be a sign your child’s asthma plan needs to be adjusted.
Is My Child at Risk of a Fatal Asthma Attack?
Combination Inhalers
For children 4 and over (as well as adults) who have moderate to severe persistent asthma (the two most severe categories of asthma), your healthcare provider may advise an inhaler containing two medications—an ICS and a drug called formoterol, along-acting beta agonist (LABA).
This combination inhaler works as both a controller medication to be used daily and as a rescue therapy to relieve acute symptoms.
Inhaler Devices and How to Use Them
Inhalers are devices that allow you to breathe medication right into the lungs. How they work depends on the type of device. The two types of inhaler devices are:
While it’s ideal to use the medication that controls asthma best, any medication is only as good as how well it is used. MDIs and DPIs each deliver medication a little differently, and your child might feel that one device is easier to use than the other.
DPIs
DPIs are breath-actuated, which means that medicine comes out as your child breathes in deeply and forcefully.
There are multidose inhalers and single-dose inhalers. For single-dose devices, you must load a capsule with the medication into the device’s chamber before use. A multidose device has the medication pre-loaded.
To use DPIs:
MDIs
MDIs release medication automatically and require coordinating a deep breath while operating the the inhaler.They contain hydrofluoroalkanes (HFAs), a substance that propels the medication with pressure.
To use MDIs:
Helping a Child Use an Inhaler
Children may have some trouble learning to use an inhaler. For example, kids who use MDIs often breathe too fast instead of taking a slow, deep inhalation when using the medication.Practicing breathing with your child without the inhaler can help them be prepared to use the device when needed.
Other common issues to work on with children:
If your child is prescribed an MDI, you can also ask your healthcare provider about aspacer. This small device has a holding chamber that keeps the medicine inside until a child takes a breath so they don’t have to coordinate inhaling with activating the inhaler.
Spacers come in different forms, including a mask for infants, toddlers, and children up to 4. A child can use a spacer for as long as they need one, typically up to age 8 to 10.
Tips for Using a Metered Dose Inhaler
Inhalers Approved for Children
Many of the inhalers used for adults can also be used in children of certain ages.
Your child’s healthcare practitioner may switch your child’s inhaler if they think a new medication they are now eligible to use may better manage their condition.
When a Nebulizer Is Used Instead
Babies and very young children with asthmawho aren’t yet able to manage an inhaler typically receive inhaled medications via anebulizer—a machine that turns the medicine into a mist.
With a nebulizer, liquid medication for asthma is placed into a cup. On one side, the cup is connected to a mask that will fit over a young child’s mouth and nose. On the other side, it’s attached to tubing. The tubing runs into a motorized device. When you turn on the motor, the liquid medication is vaporized and comes out into the mask.
Babies, toddlers, and young children don’t have to do anything to receive the correct dosage of medication. They just need to breathe in the midst. It can take some time to get your child comfortable using the mask. Arranging a simple activity that encourages them to sit still, like looking at a picture book, will help ensure they get the required dosage.
A Word From Verywell
Asthma is a chronic disease that children don’t outgrow, but they can learn to manage. Understanding how to correctly use inhalers is one step. If you have a child with asthma, their doctor will be able to determine which asthma inhalers are best for them based on their age and the severity of their asthma.
Forming an asthma action plan is also important so your child understands when the inhalers should be used and can feel calm and confident about using them when needed.
Frequently Asked QuestionsOnly a healthcare provider who specializes in treating asthma can determine whether your child needs an inhaler and what type. Signs an inhaler may be needed include a lingering cough that lasts for days or weeks, frequent wheezing, trouble breathing, and recurrent chest colds.Learn MoreMeasuring the Severity of AsthmaMost children, with adult help, can use an MDI with a spacer that ensures the child breathes in the appropriate level of medication.Most kids 5 and up can use a DPI if they can breathe in quickly and strongly.Learn MoreSide Effects of Asthma MedicationAsthma medications are safe for children and can effectively controltheir symptomsif used as prescribed. Some research shows the possibility of growth delays in children who use the inhalers long-term, but the risk is considered low.Learn MoreUnderstanding Asthma TriggersA 5-year-old may be able to work the inhaler and give themselves the appropriate dose of asthma medication, but studies show that children under 11 should still be supervised while administering their own inhaler medication.Learn MoreTips for Living With Asthma
Only a healthcare provider who specializes in treating asthma can determine whether your child needs an inhaler and what type. Signs an inhaler may be needed include a lingering cough that lasts for days or weeks, frequent wheezing, trouble breathing, and recurrent chest colds.Learn MoreMeasuring the Severity of Asthma
Only a healthcare provider who specializes in treating asthma can determine whether your child needs an inhaler and what type. Signs an inhaler may be needed include a lingering cough that lasts for days or weeks, frequent wheezing, trouble breathing, and recurrent chest colds.
Learn MoreMeasuring the Severity of Asthma
Most children, with adult help, can use an MDI with a spacer that ensures the child breathes in the appropriate level of medication.Most kids 5 and up can use a DPI if they can breathe in quickly and strongly.Learn MoreSide Effects of Asthma Medication
Most children, with adult help, can use an MDI with a spacer that ensures the child breathes in the appropriate level of medication.Most kids 5 and up can use a DPI if they can breathe in quickly and strongly.
Learn MoreSide Effects of Asthma Medication
Asthma medications are safe for children and can effectively controltheir symptomsif used as prescribed. Some research shows the possibility of growth delays in children who use the inhalers long-term, but the risk is considered low.Learn MoreUnderstanding Asthma Triggers
Asthma medications are safe for children and can effectively controltheir symptomsif used as prescribed. Some research shows the possibility of growth delays in children who use the inhalers long-term, but the risk is considered low.
Learn MoreUnderstanding Asthma Triggers
A 5-year-old may be able to work the inhaler and give themselves the appropriate dose of asthma medication, but studies show that children under 11 should still be supervised while administering their own inhaler medication.Learn MoreTips for Living With Asthma
A 5-year-old may be able to work the inhaler and give themselves the appropriate dose of asthma medication, but studies show that children under 11 should still be supervised while administering their own inhaler medication.
Learn MoreTips for Living With Asthma
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American College of Allergy, Asthma & Immunology.Asthma in Children.Asthma and Allergy Foundation of America.Asthma symptoms.Barnes PJ.Inhaled corticosteroids.Pharmaceuticals(Basel). 2010;3(3):514-540. doi:10.3390/ph3030514Cloutier MM, Baptist AP, Blake KV, et al.Focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program Coordinating Committee expert panel working group.Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003American Family Physician.Childhood asthma: treatment update.Conner JB, Buck PO.Improving asthma management: The case for mandatory inclusion of dose counters on all rescue bronchodilators.J Asthma. 2013;50(6):658-63. doi:10.3109/02770903.2013.789056Allergy and Asthma Network.How to use a dry powder inhaler.Kaplan A, Price D.Matching inhaler devices with patients: The role of the primary care physician.Can Respir J. 2018;2018:9473051. doi:10.1155/2018/9473051Food and Drug Administration (FDA).Transition from CFC propelled albuterol inhalers to HFA propelled albuterol inhalers: questions and answers.Allergy and Asthma Network.How to Use a Metered-Dose Inhaler (MDI).Gillette C, Rockich-Winston N, Kuhn JA, et al.Inhaler technique in children with asthma: A systematic review.Acad Pediatr.2016;16(7):605-15. doi:10.1016/j.acap.2016.04.006Roncada C, Andrade J, Bischoff LC, Pitrez PM.Comparison of two inhalational techniques for bronchodilator administration in children and adolescents with acute asthma crisis: A meta-analysis.Rev Paul Pediatr. 2018;36(3):364-371.doi:10.1590/1984-0462/;2018;36;3;00002Allergy and Asthma Network.How to Use a Nebulizer Machine.Volerman A, Toups M, Hull A, et al.Assessing children’s readiness to carry and use quick-relief inhalers.The Journal of Allergy and Clinical Immunology. 2019;7(5):1673-1675.e2. doi:10.1016/j.jaip.2018.11.040
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American College of Allergy, Asthma & Immunology.Asthma in Children.Asthma and Allergy Foundation of America.Asthma symptoms.Barnes PJ.Inhaled corticosteroids.Pharmaceuticals(Basel). 2010;3(3):514-540. doi:10.3390/ph3030514Cloutier MM, Baptist AP, Blake KV, et al.Focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program Coordinating Committee expert panel working group.Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003American Family Physician.Childhood asthma: treatment update.Conner JB, Buck PO.Improving asthma management: The case for mandatory inclusion of dose counters on all rescue bronchodilators.J Asthma. 2013;50(6):658-63. doi:10.3109/02770903.2013.789056Allergy and Asthma Network.How to use a dry powder inhaler.Kaplan A, Price D.Matching inhaler devices with patients: The role of the primary care physician.Can Respir J. 2018;2018:9473051. doi:10.1155/2018/9473051Food and Drug Administration (FDA).Transition from CFC propelled albuterol inhalers to HFA propelled albuterol inhalers: questions and answers.Allergy and Asthma Network.How to Use a Metered-Dose Inhaler (MDI).Gillette C, Rockich-Winston N, Kuhn JA, et al.Inhaler technique in children with asthma: A systematic review.Acad Pediatr.2016;16(7):605-15. doi:10.1016/j.acap.2016.04.006Roncada C, Andrade J, Bischoff LC, Pitrez PM.Comparison of two inhalational techniques for bronchodilator administration in children and adolescents with acute asthma crisis: A meta-analysis.Rev Paul Pediatr. 2018;36(3):364-371.doi:10.1590/1984-0462/;2018;36;3;00002Allergy and Asthma Network.How to Use a Nebulizer Machine.Volerman A, Toups M, Hull A, et al.Assessing children’s readiness to carry and use quick-relief inhalers.The Journal of Allergy and Clinical Immunology. 2019;7(5):1673-1675.e2. doi:10.1016/j.jaip.2018.11.040
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American College of Allergy, Asthma & Immunology.Asthma in Children.Asthma and Allergy Foundation of America.Asthma symptoms.Barnes PJ.Inhaled corticosteroids.Pharmaceuticals(Basel). 2010;3(3):514-540. doi:10.3390/ph3030514Cloutier MM, Baptist AP, Blake KV, et al.Focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program Coordinating Committee expert panel working group.Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003American Family Physician.Childhood asthma: treatment update.Conner JB, Buck PO.Improving asthma management: The case for mandatory inclusion of dose counters on all rescue bronchodilators.J Asthma. 2013;50(6):658-63. doi:10.3109/02770903.2013.789056Allergy and Asthma Network.How to use a dry powder inhaler.Kaplan A, Price D.Matching inhaler devices with patients: The role of the primary care physician.Can Respir J. 2018;2018:9473051. doi:10.1155/2018/9473051Food and Drug Administration (FDA).Transition from CFC propelled albuterol inhalers to HFA propelled albuterol inhalers: questions and answers.Allergy and Asthma Network.How to Use a Metered-Dose Inhaler (MDI).Gillette C, Rockich-Winston N, Kuhn JA, et al.Inhaler technique in children with asthma: A systematic review.Acad Pediatr.2016;16(7):605-15. doi:10.1016/j.acap.2016.04.006Roncada C, Andrade J, Bischoff LC, Pitrez PM.Comparison of two inhalational techniques for bronchodilator administration in children and adolescents with acute asthma crisis: A meta-analysis.Rev Paul Pediatr. 2018;36(3):364-371.doi:10.1590/1984-0462/;2018;36;3;00002Allergy and Asthma Network.How to Use a Nebulizer Machine.Volerman A, Toups M, Hull A, et al.Assessing children’s readiness to carry and use quick-relief inhalers.The Journal of Allergy and Clinical Immunology. 2019;7(5):1673-1675.e2. doi:10.1016/j.jaip.2018.11.040
American College of Allergy, Asthma & Immunology.Asthma in Children.
Asthma and Allergy Foundation of America.Asthma symptoms.
Barnes PJ.Inhaled corticosteroids.Pharmaceuticals(Basel). 2010;3(3):514-540. doi:10.3390/ph3030514
Cloutier MM, Baptist AP, Blake KV, et al.Focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program Coordinating Committee expert panel working group.Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003
American Family Physician.Childhood asthma: treatment update.
Conner JB, Buck PO.Improving asthma management: The case for mandatory inclusion of dose counters on all rescue bronchodilators.J Asthma. 2013;50(6):658-63. doi:10.3109/02770903.2013.789056
Allergy and Asthma Network.How to use a dry powder inhaler.
Kaplan A, Price D.Matching inhaler devices with patients: The role of the primary care physician.Can Respir J. 2018;2018:9473051. doi:10.1155/2018/9473051
Food and Drug Administration (FDA).Transition from CFC propelled albuterol inhalers to HFA propelled albuterol inhalers: questions and answers.
Allergy and Asthma Network.How to Use a Metered-Dose Inhaler (MDI).
Gillette C, Rockich-Winston N, Kuhn JA, et al.Inhaler technique in children with asthma: A systematic review.Acad Pediatr.2016;16(7):605-15. doi:10.1016/j.acap.2016.04.006
Roncada C, Andrade J, Bischoff LC, Pitrez PM.Comparison of two inhalational techniques for bronchodilator administration in children and adolescents with acute asthma crisis: A meta-analysis.Rev Paul Pediatr. 2018;36(3):364-371.doi:10.1590/1984-0462/;2018;36;3;00002
Allergy and Asthma Network.How to Use a Nebulizer Machine.
Volerman A, Toups M, Hull A, et al.Assessing children’s readiness to carry and use quick-relief inhalers.The Journal of Allergy and Clinical Immunology. 2019;7(5):1673-1675.e2. doi:10.1016/j.jaip.2018.11.040
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